Does Medicaid Cover Hearing Aids for Adults? How to Check

For adults 21 and older, Medicaid covers hearing aids only in states that choose to, because federal law makes them an optional benefit.1 For Medicaid enrollees under 21, federal law requires hearing aids as part of their screening and treatment benefit.2 Here's how to get your own state's answer, and what to do if it's no.

In This Guide

• Does Medicaid Cover Hearing Aids for Adults? Only If Your State Opts In
• Covered Can Still Mean Limited
• What You Need to Get a Hearing Aid Through Medicaid
• How Fast Medicaid Must Decide a Prior Authorization
• Under 21: Medicaid Must Cover Hearing Aids
• How to Check Whether Your State's Medicaid Covers Hearing Aids for Adults
• If You Have Medicare Too
• If Medicaid Says No
• Frequently Asked Questions
• Learn More

Does Medicaid Cover Hearing Aids for Adults? Only If Your State Opts In

Federal rules define Medicaid hearing services at 42 CFR 440.110 to include "any necessary supplies and equipment." They aren't among the services 42 CFR 440.210 requires for the categorically needy, and 42 CFR 440.225 lets a state furnish services not required under 440.210 and 440.220 at the state's option.1 So whether an adult has coverage turns on that state's choice.1 More on optional benefits: what Medicaid covers.

Children are on a separate track: Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) is Medicaid's benefit for enrollees under 21, covered below.2 Four states show the range for adults:

Covered Can Still Mean Limited

Under 42 CFR 440.230, a state Medicaid agency may place appropriate limits on a service based on criteria such as medical necessity or utilization control, but each service must be sufficient in amount, duration and scope to reasonably achieve its purpose.10 Florida's hearing policy, for example, covers one new hearing aid per ear every three years, and providers must get authorization from the state's quality improvement organization to exceed that limit.6

A state's contract with a Medicaid managed care plan must require services in no less amount, duration and scope than the same services under fee-for-service Medicaid.11

What You Need to Get a Hearing Aid Through Medicaid

Federal rules describe Medicaid hearing services as provided by or under the direction of a speech pathologist or audiologist, for a patient referred by a physician or other licensed practitioner.1 States add their own steps:

• A doctor's exam and recommendation. Alabama, for the enrollees it covers, conditions approval on a medical examination and a licensed physician's recommendation for a hearing evaluation, made within six months of the fitting.7
• An approved dealer. Alabama provides hearing aids through dealers contracted with its Medicaid Hearing Aid Program.7
• Authorization past the limits. Florida requires authorization from its quality improvement organization to exceed its hearing aid and assessment limits, or for someone who doesn't meet its hearing-loss criteria.6

Where your state requires prior authorization, the decision clocks below apply.10

How Fast Medicaid Must Decide a Prior Authorization

Since January 1, 2026, a state Medicaid agency must make a standard prior authorization decision on an item or service other than a drug within 7 calendar days of the request, unless state law sets a shorter time. The agency can extend that by up to 14 calendar days if you or your provider asks, or if it needs more information from the provider, and an expedited decision is due within 72 hours.10 The agency must send you notice of its decision and give you fair hearing rights.10

Medicaid managed care plans must make standard authorization decisions within state time frames of no more than 7 calendar days for rating periods starting on or after January 1, 2026, with a possible extension of up to 14 more calendar days.11 Applicable integrated plans' decision and notice timelines must comply with 42 CFR 422.629 through 422.634, in lieu of 42 CFR 438.404 through 438.424.11 Under 42 CFR 422.561, applicable integrated plans include, when the rule's conditions are met, a fully integrated or highly integrated dual eligible special needs plan with exclusively aligned enrollment, or a dual eligible special needs plan and affiliated Medicaid managed care plan.12

Under 21: Medicaid Must Cover Hearing Aids

EPSDT covers Medicaid enrollees under 21, and its hearing services "shall at a minimum include diagnosis and treatment for defects in hearing, including hearing aids" (42 U.S.C. 1396d(r)(4)(B)). It also reaches other necessary treatment to correct or ameliorate conditions found by screening, "whether or not such services are covered under the State plan" (42 U.S.C. 1396d(r)(5)).2

Alabama's rule shows the split: it limits hearing aids to enrollees eligible for EPSDT.7 Florida's hearing policy says services for recipients under 21 that exceed its limits may be approved if medically necessary.6 See how Georgia runs EPSDT.

How to Check Whether Your State's Medicaid Covers Hearing Aids for Adults

1. Find your state's hearing services coverage policy. Start from our Medicaid by State guide to reach your state's Medicaid agency, then search its site for "hearing services" with "provider manual" or "coverage policy." Look for age limits, hearing-loss levels and replacement intervals.
2. Call member services on the Medicaid card. Ask whether adult hearing aids are covered, what loss qualifies, and how often they're replaced.
3. Get any denial in writing. Appeal and fair hearing deadlines are counted from the notice, so keep it.13,14

Georgia shows another pattern. The Georgia Division of Family and Children Services' Medicaid manual says the Georgia Hearing Aid Distribution Program serves people 18 or older because Georgia Medicaid provides hearing aids to those under age 18.8 The Georgia Public Service Commission, which has contracted with the Georgia Charitable Care Network for the program, says it serves Georgians of all ages and limits adult applicants' income to 200% of the federal poverty guidelines.9 Our Georgia hearing aid guide covers it.

If You Have Medicare Too

Medicare doesn't cover hearing aids or exams for fitting hearing aids. Medicare covers diagnostic hearing and balance exams if your doctor or other health care provider orders them to find out if you need medical treatment.3 Medicare covers certain devices that replace the function of the middle ear, cochlea or auditory nerve, including cochlear, auditory brainstem and osseointegrated implants, as prosthetic devices.15 See Medicare and hearing aids.

Plans that may add hearing benefits. Some Medicare Advantage plans offer extra benefits Original Medicare doesn't cover, like hearing, so contact the plan to see what it covers.3 A dual eligible special needs plan (D-SNP) is a Medicare Advantage plan for people entitled to Medicaid that coordinates Medicare and Medicaid services.16 A PACE plan may also cover extra benefits Original Medicare doesn't, like certain hearing services.15

Full Medicaid or a Medicare Savings Program? People with both Medicare and Medicaid include those with full Medicaid benefits and those who get help with Medicare premiums or cost-sharing through a Medicare Savings Program (QMB, SLMB, QI or QDWI). Medicaid may cover medical costs that Medicare doesn't.16 So if you have full Medicaid and your state covers adult hearing aids, ask Medicaid.1 SLMB and QI cover only Part B premiums, and QDWI covers only Part A premiums.16 In Texas, STAR+PLUS lists vision and hearing care among its services, but members who have both Medicare and Medicaid get only their long-term services and supports through STAR+PLUS, so ask how a hearing aid is handled for you.5

If Medicaid Says No

A Medicaid managed care plan's denial notice must explain its reasons and your appeal rights.17 Unless you're in an applicable integrated plan, you have 60 calendar days from the date on the plan's denial notice to appeal to the plan, orally or in writing; if you are, the plan's appeal rules fall under 42 CFR 422.629 through 422.634 instead.13 If the plan upholds its denial, or fails to follow the federal notice and timing rules for appeals, you can request a state fair hearing.18 After a plan's notice upholding the denial, you get no less than 90 and no more than 120 calendar days from that notice to request the hearing.18

For a decision by the state Medicaid agency itself, the state must allow a reasonable time, not more than 90 days from the date the notice is mailed, to request a fair hearing. That's a ceiling: Georgia, for example, allows 30 days, so check the deadline your own state sets.14 See our Medicaid appeals guide.

Other places to turn:

• Over-the-counter hearing aids suit mild to moderate loss only: the FDA says they aren't meant for severe or profound loss.19
• Nonprofits may help pay for hearing aids or provide used or refurbished ones, says the National Institute on Deafness and Other Communication Disorders (NIDCD). You can call NIDCD toll-free at (800) 241-1044 with questions about organizations that offer financial help with hearing aids.20
• VA health care furnishes needed hearing aids to veterans in VA care who fall in a listed group, such as those with a compensable service-connected disability.21 See VA hearing and vision care.

Learn More

Find personalized help checking your state's Medicaid hearing aid coverage at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.